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Birth Boot Camp: Training for an Amazing Hospital Birth
Class Dates: Every Tuesday, November 6 - December 11, 2018
Class Time: 6-8:30pm
Location: The Happy Mama Place, Wilkes Barre Pa
1325 North River Street, Plains, Pa 18702 (Tuft-Tex Complex) (Your GPS may say Wilkes Barre)
Contact Info: Heather Whitcomb (570)542-2229, Heather@ButterflyDoula.com,
Cost: $250 ($225 for ealry registration)
Regsister by August 4th and you save $25!

Full class description and other class options can be found at www.ButterflyDoula.com/childbirth-classes/

Financial Agreement
The cost of this class is $250. A non-refundable deposit of $75 is due with your registration. In order to recieve the early registration discount of $25 you must be registered and pay the deposit by October 6, 2018. The balance is due at the beginning of the first class. You may pay by cash or check by mail, paypal or with a credit card in person at the first class. Any refunds given after the first class will be at the discresion of the instructor. By completing this form you are agreeing to these financial terms.

Please make checks payable to Butterfly Birth Services LLC.

Payments can be mailed to,
Heather Whitcomb
33 Elmer St
Ashland, Pa 17921

Paypal address Heather@ButterflyDoula.com

Email address *
Mother's Name *
Your answer
Partner's Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Estimated Due Date *
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DD
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Where do you plan to give birth? *
Your answer
Who is your care provider? *
Your answer
What do you hope to learn in this class? *
Your answer
How did you find out about this class? *
If you were referred by a friend, provider or another person, please let me know who. I love to thank them for their support.
Your answer
How would you like to pay for your class? *
A copy of your responses will be emailed to the address you provided.
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